Flatwork vs. Fold Dry: Why the Shift in Products?

Eric Frederick |

I was working on a productivity improvement project and had the occasion to determine my product mix between ironing and fold dry work. When I first started in this business back in 1972, our mix was 80% iron and 20% fold dry. My calculations are now 25% iron and 75% fold dry. This product-mix change didn’t surprise me, but it got me thinking about what’s changed and why.
In 1972, my healthcare laundry processed only flat white or green sheets. Contour sheets were difficult to process, but processing flat sheets was fast and efficient. It isn’t the use of percale contour sheets but the shift to knitted fitted sheets that changed the mix. They represent 10% of my total workload.
The advent of small-piece folders presented another significant change. In 1972, we had just one towel folder and ran as much as we could through the ironer – including bath blankets and patient gowns – to take advantage of the four-lane folders on the back. Once small-piece folders were perfected, laundry managers found that running patient gowns through them increased a gown’s life and hand. IV gowns wouldn’t do well in an ironer and thus were hard to find in 1972. Today, it’s the gown type that’s used the most. Patient gowns account for 9.25% of my total volume.
When small-piece folders were designed to handle bath blankets, most managers quickly opted for them. But a dry-folded blanket had a nicer hand and lasted longer than an ironed blanket. Bath blankets represent 13.5% of my total volume.
We ironed OR towels, OR wrappers and OR drape sheets made of T-140 muslin or T-180 percale in '72. The central service department inspected the surgical linen. We strived to process it as quickly as possible and deliver it, but we learned over the years that ironing OR linen breaks fibers and causes lint.
Manufacturers developed a single-use product that performed better than either percale or muslin fabrics. Many laundry managers were happy to see the troublesome product disappear. The textile manufacturers have developed a new generation of OR linen that shouldn’t be ironed. This category of linen is dried, inspected, folded and wrapped in surgical pack rooms. My OR linen percentage has dropped from 10.7% of total work in 1972 to 3.5% in 2007.
In 1972, every bed had to have a corded bedspread that required washing and ironing. Textile manufacturers developed and effectively marketed colored thermal spreads as an alternative. Today, I no longer process bedspreads.
The reusable incontinent pad has impacted product mix. Thirty-five years ago, this item wasn’t used in hospitals. Textile companies developed a good product and effectively sold it against the disposable alternative. Reusable incontinent pads represent 8.3% of my volume today.
Many laundries have gone away from ironing scrubs, either drying and folding them or running them through a steam tunnel.
The shift to more fold dry work helps explain why so many laundries have fallen short on dryer capacity. We’ve continued to add capacity but are always one step behind the product-mix change. The laundry facility of today is much different than the one designed back in 1972.
I think the healthcare laundry mix will move from 75/25 to 80/20 over the next few years. Further changes will be driven by the textile industry and the type of products developed and marketed. While I doubt that flatwork will ever represent less than 20% of the mix, I’ve learned to never say never.

About the author

Eric Frederick

Carilion Laundry Service

Director of Laundry Services

Eric Frederick is director of laundry services for Carilion Laundry Service, Roanoke, Va., and past president of the National Association of Institutional Linen Management (NAILM), now called the Association for Linen Management (ALM). He’s a two-time association manager of the year. You can reach him by e-mail at


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